Related Topics

How Much Is Usually Taken by Dieters?

The standard recommendation for mild to moderate depression is 500 to 1,050 mg of St. John’s wort extract per day.1, 2, 3 Length of use should be discussed with a healthcare professional.

Side Effects

St. John’s wort has a low incidence of side effects compared to prescription antidepressants. An adverse events profile of St. John’s wort found that, of 14 controlled clinical trials, seven reported no adverse reactions, two had no information, and five reported a total of seven mild reactions.4 Adverse effects reported included stomach upset, fatigue, itching, sleep disturbance, and skin rash. The rate of adverse reactions was always similar to that of the placebo. Additionally, in seven trials comparing St. John’s wort with other antidepressants, the adverse reaction rate for St. John’s wort was consistently lower than that of the antidepressant drugs with which it was compared.

St. John’s wort can make the skin more sensitive to sunlight.5 Therefore, fair-skinned people should be alert for any rashes or burns following exposure to the sun. Three cases of severe blistering and burns were reported in people taking St. John’s wort internally or applying it topically and then being exposed to sunlight.6 There is a case report of a woman experiencing neuropathy (nerve injury and pain) in sun-exposed skin areas after taking 500 mg of whole St. John’s wort for four weeks.7 Although St. John’s wort has photosensitizing properties, the severity of this reaction is not typical for people taking the herb.

People with a history of manic-depressive illness (bipolar disorder) or a less severe condition known as hypomania, should avoid use of St. John’s wort as it may trigger a manic episode.8, 9, 10, 11

There is a single case report in which ingestion of St. John's wort appeared to cause high blood pressure in a 56-year-old man. The blood pressure returned to normal when the herb was discontinued.12

Interactions with Supplements, Foods, & Other Compounds

Caution: It is likely that there are many drug interactions with St. John's wort that have not yet been identified. St. John's wort stimulates a drug-metabolizing enzyme (cytochrome P450 3A4) that metabolizes at least 50% of the drugs on the market.13 Therefore, it could potentially cause a number of drug interactions that have not yet been reported. People taking any medication should consult with a doctor or pharmacist before taking St. John's wort.

The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2016.

*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.

Information provided on this site is solely for informational purposes only.
It is not a substitute for professional medical advice. Do not use this information for
diagnosing or treating a health problem or disease, or prescribing of any medications or
supplements. Only your healthcare provider should diagnose your healthcare problems and
prescribe treatment. None of our statements or information, including health claims, articles,
advertising or product information have been evaluated or approved by the United States Food
and Drug Administration (FDA). The products or ingredients referred to on this site are
not intended to diagnose, treat, cure or prevent any disease. Please consult your healthcare
provider before starting any supplement, diet or exercise program, before taking any medications
or receiving treatment, particularly if you are currently under medical care. Make sure you
carefully read all product labeling and packaging prior to use. If you have or suspect you
may have a health problem, do not take any supplements without first consulting and obtaining
the approval of your healthcare provider.
California Consumers – Proposition 65 requires sellers to notify California consumers
of substances that are in many foods, plants, herbs and supplements with the following warning.
WARNING: These products contain chemicals known to the State of California to cause birth
defects or other reproductive harm.